Dr. Mona Knows: How To Open Up About Sex...And How To Stop Dieting Once And For All

10/11/2007 08:00 am ET | Updated Nov 17, 2011

Please send your questions to me, Dr. Mona Ackerman, by posting them in the comments section below. I look forward to answering them and continuing our conversation!

Q: I don't want to tell my therapist about my sex life. I went into therapy last year for the first time at the age of 26 because my parents died within three months of each other. My therapy has been enormously helpful in dealing with my grief, my pain, my guilt, my financial fears, and my loneliness. I am ready to now begin dating and to find a relationship, but I am also enjoying going to sex clubs and playing some anonymous sado-masochistic games. It scares me a little, but it scares me more to bring it up in therapy. Should I go to a sex therapist?

A: In any relationship or in any personal search, there will come a moment of truth. But hopefully a relationship of trust has been established between you and your therapist, and you have learned a language by which you can communicate what you feel and what is happening when progress is blocked.

You are now at that moment. You need to try and continue. If the therapy has been helpful, stay with it and try to understand why you are hesitant to expose yourself even more. Or try to understand why your relationship with your therapist is not as trusting and safe as we would hope.

I suspect that what you want to pursue in your therapy is your need to find new paths as you emerge into a fuller adulthood. You are exploring new freedoms, new identities and new friends. And at the same time, the loss of parents leaves a void that we try to fill for the rest of our lives. We try to find new parents sometimes through the therapist, through friends, through employers, or through sexual partners. We continue to want someone to take care of us and to tell us what to do. So, whereas the therapist may be playing the role of parent in supporting your conflicts, he or she is also the parent that you can't bring yourself to confess your sexual exploration.

As long as you are safe and are not skirting self-destructive paths, keep pursuing your own needs, including new and old relationships - like the one you have with your therapist.

Q: I am one of those perpetual dieters. Over 55 years, I have successfully tried every weight loss technique. My problem is not the dieting--it is the maintenance. I begin to return to overeating and then the weight returns. Do I just have to keep dieting forever?

A: Most authorities will emphatically state that you need to change your focus from dieting and losing weight to getting a healthy attitude toward food. In other words, don't worry about losing weight. Instead, strive for a lifestyle that includes natural foods and a balanced menu plan.

That being said, your therapist, me, has something else to add. You need to understand what your historical behavior has been and what it tells you. You do well within the STRUCTURE of a diet. Its rules define what to do and not, as it should be, rules that come from within yourself.

It seems to me that when the structure of the diet has ended, your own need to indulge, to comfort and spoil yourself reemerges. The question, therefore, is what is represented by that? Why is eating food excessively perceived as a gift to yourself?

Along with the structure of dieting, it may be valuable to determine and understand the historical patterns of chaos and/or pain in your life. And when in your life you were presented with problems and conflicts, how did you get into the groove of immediate food gratification? Instead of avoiding pain by eating -- in essence, eating your way out of one pain and into another-- it is possible to let the awareness and the knowledge of pain wash over you? Just sit with it. And while you are in touch with your sad or fearful emotions, you can begin to construct new ways to indulge yourself. You can find ways to be good to yourself that are not self-destructive. Being proud of yourself and your physical and emotional strengths is the first step in the appreciation and acceptance of a healthy lifestyle.